Gun Violence and Public Health: For Our Lives, Lives Lost and Lives Forgotten

Seventeen dead in Parkland. Twenty-six dead in Sutherland. Forty-nine dead in Orlando. Twenty-seven dead at Sandy Hook. Fifty-eight dead in Las Vegas. As death tolls continue to climb and the frequency of mass shootings increase, gun violence has become one of the leading causes of premature death, killing more than 30,000 people and causing nearly 85,000 injuries per year in the United States [2]. “Enough is enough,” cried protesters in the national March For Our Lives rally held nationally on Saturday, March 25.

Marching in unison, demonstrators filled the streets across the nation and called for action against gun violence. Hundreds of thousands of marchers filled with passion, angst, anger and grief for the lives lost due to gun violence, chanted loud and proud that they demanded a new era of progression—progression into a future without the fear of violence and guns.

While the discussion around gun violence has been largely political, politicians and experts are realizing that gun violence is not only a public health issue, but a major one in other areas as well. However, little effort and research has been placed into delving deeper into analyzing and evaluating the distribution and use of guns. Despite the increasingly large number of mass shootings in the U.S., there have yet to be solutions implemented to decrease the likelihood of mass shootings from occuring. Dr. William Powderly, Director of the Global Health Center at WUSTL, explains the intersectionality of gun violence and public health.

“The deaths and injuries as a result of gun violence are a very clear public health issue,” Powderly said. “It’s more than the people who die from HIV infection in the United States, [and] everybody would agree that HIV is a public health issue. When you put it in perspective, people [are] dying from something that is potentially preventable. [Thus,] death and injury from guns is a public health issue.”

In the Journal of the American Medical Association, a study discovered that from 2004 to 2015, research related to gun violence was “substantially underfunded and understudied” compared to other leading causes of death based on mortality rates [4]. In 2015, gun violence research received 1.6 percent of its funding from the government, $22 million, out of the predicted, $1.4 billion that gun violence research should’ve received based on the number of deaths caused by guns [4]. Which brings into question: why is the government seemingly ignoring the country’s ongoing gun crisis?

For several years, many experts have questioned if having a gun in one’s home truly protects a household. In 1933, a landmark study demonstrated that the presence of a firearm increased the chances of gun-related fatalities. After this study was published, the National Rifle Association (NRA) quickly disputed the study’s findings and pushed Congress to stop the Centers for Disease Control and Prevention (CDC) from spending taxpayer money on research that advocated gun control. In 1996, Congress passed the Dicky Amendment, which cut funding to and eventually ended the CDC’s gun violence studies effort. While the Dickey Amendment did not directly prohibit the CDC from studying gun violence, it cut the CDC’s budget by the exact amount that it had directed towards gun research [1]. Since the passage of the amendment, the government and other institutions have repeatedly and consciously turned their back on this most pressing issue of society today. Focusing on the preventable measures of gun violence, Dr. Sean Joe, who serves as the Benjamin Youngdahl Professor of Social Development and Associate Dean for Faculty and Research, believes that research is an integral part to furthering the prevention of gun-related incidents and deaths.

“More needs to be done. Not only because we have unanswered questions, but because we have a moratorium on gun-related science. If we don’t have the science to at least understand the magnitude of the problem, then that leads to [an] inability…to address the problem,” Joe said. “Once you stop asking the question for any disease or any health problem on how’s it occuring, why is it occuring and what’s the mechanism used, it’s hard to intervene. You have to advance science in that way.”

The gun violence issue in society deals with two factors: policy and research. On the political spectrum, many wonder whether or not policy changes and/or prevention have the ability to decrease gun-related deaths and injuries. Which is what inspired Andrew R. Morral, a behavioral scientist at the Research and Development (RAND) Corporation, to conduct a study on whether background checks reduced the incidences of suicides and homicides. He found that these policy changes did lead to decreased suicide and homicide rates. In addition, Morral’s study reported that the stand-your-ground laws, which allow people to use guns in order to defend themselves without trying to retreat first, could potentially increase the murder rate [1].

On the research spectrum, Congress has continuously refused to include funding for gun violence research proposals. After the Sandy Hook school shooting in 2012, President Obama encouraged the CDC to further gun violence research; however, there was never any progress or follow-up. The National Institutes of Health (NIH) has funded some studies on gun-related incidents, including violent crimes associated with drug and alcohol consumption, parental roles in preventing injury, suicides and accidental deaths. Among these research topics, suicide accounts for more than 60 percent of gun deaths [1].

Outside of the research field, justice in gun violence has also been pushed for in political departments. The Justice Department minimally contributes to gun violence research through its small allotment in the budget for this type of research. Private institutions have attempted to fill the gap; However, there is a legal blockage that private money cannot cross—the Tiahrt Amendments, which prevent the Bureau of Alcohol Tobacco, Firearms and Explosives from sharing firearms tracking database with anyone outside of law enforcement. These amendments inhibit researchers from accessing the records that are crucial to analyzing the flow and usage of guns, which becomes a major limitation in terms of the breadth and depth of research conducted by private corporations.

While the majority of current gun violence conversations in society focus primarily on mass shootings due to a dramatic increase in these incidences, this has caused other issues of gun violence, especially suicides, to lose prevalence in public health. As his main focus of work, Joe finds this as a pressing issue that must be addressed in addition to mass shootings to ensure that those who have been lost to gun-related deaths or injuries are not forgotten.

“We should try our to best to let people know that if you’re talking about firearm injury in the United States, and suicide doesn’t come out as your first focus, then you’re missing the conversation,” Joe said. “There are other fire-related injuries that are important for us to pay attention to, but a majority of gun violence in US is about suicide, and we have to match our interests and understand that that’s also a priority we have to address.”

In response to these public health crises of both mass shootings and suicides, WUSTL created a program to further gun violence research. Launched in spring 2015 by Chancellor Mark S. Wrighton, the Gun Violence Initiative was created in order to look at death and injury due to gun violence. As one of the contributing members of the Gun Violence Initiative, Powderly explains the severity of the issue and why it needs to be addressed.

“One of the reasons we started the Gun Violence Initiative, which is part of the Public Institute of Health, was really to try and continue to create the discussion in our society about the fact that this many deaths every year is really not something we should be satisfied with,” Powderly said. “This is not something we should say ‘oh, it’s not a problem.’ It is a problem. It’s a big problem.”

The purpose of this initiative is to answer three main questions: “what we know, what we need to know and what to do about this critical issue” [3]. Through reaching out to national experts, partners and stakeholders throughout the community, WUSTL seeks to better understand and raise awareness around the realities of gun violence. With the new information, WUSTL will be able to identify gaps in available data and research, empower policymakers and the public with accurate information to guide decision-making and find measures that lead to action and progression towards the reduction of gun violence in the United States [3]. At the launch event for the Gun Violence Initiative, the chancellor gave a speech, providing hope for the future.

“Bringing together our academic strengths to address major societal challenges is part of our mission,” Chancellor Wrighton said. “Our goal, by engaging in the conversation, is to help develop real solutions that have a real chance of making a real difference and, in the process, help to reduce death and injury from firearms.”